An esophageal stricture is a narrowing of the esophagus, the passageway from the throat to the stomach. Stomach acid, accidentally swallowed harsh chemicals, and other irritants may injure the esophageal lining, causing inflammation (esophagitis) and the formation of scar tissue. This may gradually lead to obstruction of the esophagus, preventing food and fluids from reaching the stomach.
What Causes Esophageal Stricture?
- Persistent reflux of gastric acid into the esophagus or gastroesophageal reflux disease (GERD)
- Systemic sclerosis (scleroderma), which is often associated with severe reflux and esophageal stricture
- Swallowing lye or other corrosive chemicals
- Pills lodged in the esophagus or medications that can irritate the esophagus
- Esophageal surgery or protracted use of a nasogastric tube (used in hospitals for feeding)
- Esophageal cancer may narrow the esophagus and produce the same symptoms
- Accidental injury caused by an endoscope
Symptoms of Esophageal Stricture
- Progressive swallowing difficulty, first with solid foods, then liquids; chest pain after meals; increased salivation
- Regurgitation of foods and liquids. These may be aspirated into the lungs, causing cough, wheezing, and shortness of breath.
- Weight loss
- Cough, particularly at night
Prevention of Esophageal Stricture
- Aggressive treatment of chronic gastroesophageal reflux is necessary.
- Store all corrosive chemicals where they will be inaccessible to children.
- Take all pills with a full glass of liquid.
Diagnosis of Esophageal Stricture
- A medical history and physical examination are performed.
- Barium x-ray studies. You may be required to swallow barium, which helps to create a sharp image of the esophagus on an x-ray.
- Endoscopy (insertion of an illuminated scope into the esophagus through the mouth under local anesthesia) may be performed.
How to Treat Esophageal Stricture
- Your doctor may advise a diet of liquids or soft foods until food can be swallowed without difficulty.
- Mechanical dilation of the esophagus (esophageal bougienage) may be performed to widen the stricture.
- Proton pump inhibitors or acid-blocking medicines are used to prevent esophageal strictures caused by GERD from recurring.
- In severe cases the affected portion of the esophagus may be removed and replaced with a segment of the large intestine.
- In a few cases patients who are unsuited for surgery may have a feeding tube inserted through the stricture. Alternatively, such patients may have a small tube placed into the stomach (gastrostomy), so that food may bypass the esophagus completely.
When to Call a Doctor
- Call a doctor if you experience progressive difficulty in swallowing.
- EMERGENCY Call an ambulance if someone has swallowed a corrosive material.
- EMERGENCY Go to an emergency room if food becomes stuck in the esophagus and cannot be dislodged by drinking water or other maneuvers.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media